Certification examinations for massage therapists: A psychometric analysis

Objective: To describe the components of the Alberta Registered Massage Therapists Society (ARMTS) examination and their psychometric properties. Methods: All 3 components of the ARMTS examination (knowledge, clinical judgement, and clinical skills) were administered to 112 candidates. The examination consisted of 2 written components (140 multiple-choice questions on basic science knowledge and 60 multiple-choice questions on clinical judgment) and a clinical competency assessment of the following practical skills with standardized patients: (1) taking a case history, (2) assessing physical condition, and (3) treating the condition. All components of the examination were criterion-referenced with the methods of minimum performance level (MPL). Results: The internal consistency reliability coefficients (Cronbach α) ranged from 0.60 to 0.88 for all test components. The descriptive statistics, performance levels, and reliability estimates indicate that the examination is functioning well. Concurrent, criterion-related validity evidence was provided by correlations between the examination components that ranged from r = 0.24 (P < .05) to r = 0.78 (P < .01). Factor analysis produced 3 factors: information processing, clinical treatment, and follow-up management. Conclusions: The results provide evidence of adequate-to-good internal consistency reliability and content validity. Empirical validity evidence based on concurrent, criterion-related measures is provided by the correlational analysis. The significant correlations indicate that although performance is related across the examination, the various components do assess unique and independent domains. This is further supported by the results of the factor analysis that provide evidence for discriminant validity of the measures (ie, they discriminate between domains of measurement such as information processing, treatment, and basic knowledge). Taken together, these results indicate that the ARMTS examination has evidence for both reliability and validity.